High Risk Humor

     As I mentioned in my last post, I will be seeing a high risk specialist for the duration of my pregnancy. Wednesday at my 13 week mark, we met him for the first time. Our specialist is seriously hilarious! He made both my husband and I so comfortable that it helped ease the stress of a high risk pregnancy. Since the day I found out I was pregnant, I have been even more of a worrier. It's something my husband calls me out on a lot. My worry level got so high that I was near to having panic attacks, which would obviously not be helpful during pregnancy. So, I prayed. Hard. I prayed that God would take away the worry just enough that I wouldn't be reckless, but that I also could get through the day. Every time a new issue has come up, or a new doctor has been introduced, I want to worry. But, I don't. At least not beyond the normal level of worry all pregnant women face.
     Our specialist is a perfect example of God loudly answering this prayer. He actually told me, "God has this baby and your pregnancy under control. You take care of you, and God and I will take care of the baby." Doctors don't normally say things like that, and maybe he felt he could get away with it, because I was literally praising God in his office as he was walking us through some incredible news! Either way, my heart was comforted. I have to admit, I'm still nervous, but it's much closer to an appropriate amount than it used to be.
     So here's the good news... First, the ultrasound he preformed was a Nuchal Translucency Screening. This ultrasound test is used to measure the back of the baby's neck and the tip of the nose. Babies that have Down's Syndrome or heart disorders have thicker necks than babies that do not. This test is an early indicator that the baby could have complications. Since it can be completed in your first trimester, a lot of people elect to have it. We didn't really elect this test, but our specialist always does it anyway. Our test revealed no abnormalities in the neck!!! The doctor told us we could have more blood test run to be 100% sure, but my husband and I decided not to. I'm not a fan of needles, and anytime I can choose not to have one stuck in the only good vein I have, I take it.
     Other good news followed. I am a carrier for Factor V, but I DO NOT have it!!! If I had a history of blood clots, injections would be encouraged, but since I don't I am off them for now. I still have to take the baby aspirin until I reach 36 weeks, but that's it. I can also skip the extra folic acid, because he changed my prenatal vitamins. These vitamins may also stop me from throwing up everyday. The first morning, they did help with the nausea, and so far I've kept everything down. I have been throwing up nearly everyday, and not always in the morning. In fact, when we arrived at the doctor for a 2pm appointment, I threw up in the bathroom. In addition to throwing up on myself, I also peed my pants because I couldn't hold it anymore. It was seriously embarrassing, because we hadn't even seen the doctor yet. So there I sat in puked, peed clothes. I guess I am just preparing myself for the mess I will be once the baby comes.
     Speaking of the baby... It's a boy!!! A healthy, strong boy, who moves A LOT! I can't feel him yet, but every ultrasound we have he's wiggling. Our specialist said, "healthy babies move a lot, and he hasn't stopped moving since I started this ultrasound." Although the doc said he can only be "80% sure" that this little one was a boy, we have some pretty convincing ultrasounds with his little peen at full mast. To which our doctor said, "Looks like his daddy in the morning, huh." Hilarious!
     We will go back to the specialist on Halloween for another ultrasound. This pattern will continue throughout my pregnancy. And just like any other OB, the frequency of visits will continue as I get further along. Although the specialist is not my delivering doctor, he will have final say about when our little boy should debut. It still looks like I will be induced at 38 weeks, which means Baby Watkins is coming in March, not April.
     As far as naming the little boy goes, my husband and I have been trying for so long that we long ago picked out names we liked. This little boy will be named James Bauer Watkins. James is my husband's and father-in-law's middle names, and my all-time favorite boys' name. Bauer is my mother's maiden name. My grandparents only had one son, and he passed away before he had any children. I have always wanted to hand the name down, because my great-grandparents brought it over from Hungary. It is my heritage. And, I am proud to be Hungarian. My grandparents were and are such an important part of my life that I cannot imagine Bauer disappearing when my grandfather passes. Our son will, essentially, be named after both of us. It is likely, we will call him J.B. for short, which I personally think is adorable!
     It is such a relief to have great news after such a long battle. I really have my readers to thank. I feel your prayers for us. I feel blessed. I cannot believe I get to be a mother. I get to raise a son. And, my husband is such an amazing man that I know our son will have a great role model as he grows up. And, as much as I expect I will be peed on every time I change his diaper, I couldn't be happier. God is good! Amen.

April's due in April

     It’s been a little over 12 weeks since I last wrote a blog post. Since that time, a lot of very exciting things have happened. In my last post, I mentioned that I had five needles in my body in five days. It ended up being a lot more. In all, I had 12 shots of Bravelle to produce eggs, three shots of hCG to ovulate, and eight blood draws to check hormone levels. I had two follicles present at ovulation. Two chances to conceive. My husband and I decided to try having sex to conceive instead of the recommended IUI, because we wanted one try to be “normal”. That meant, we had to abstain from sex the day of my hCG trigger shot, and then have sex the next three days in a row. As fun as that may sound, that’s a lot of work. In addition to the 15 shots, I was put on estrogen pills and progesterone vaginal suppositories. These supplements are supposed to maintain a pregnancy if there is one, but they need to be started before pregnancy can be confirmed. The estrogen was nothing new, but the progesterone was disgusting! Twice a day I had to lie flat on my back for half an hour while this pill dissolved into a cream, which continued to leak out of me all day. It’s very unpleasant!!! But, I was diligent, because I knew the goal.

     A week after my trigger shot, I went to the doctor to discuss what our next cycle would be, assuming that I was not pregnant. Our doctor strongly encouraged us to move to IUI next cycle for better odds. We agreed that was probably best. The day before this appointment, I had some spotting, which I noticed shortly after sex. I assumed that the spotting meant a period was coming soon, and that this cycle was a bust. But, my heart was prepared. This was our first cycle at this clinic, and there was absolutely no way it would work that quickly.

            On Friday July 27^th, I went back to the doctor to simply have a pregnancy blood test.  Nearly the entire week before the test, I had all the classic early pregnancy symptoms (nausea, peeing a lot, fatigue), but that’s really common with the hCG shot, because you’re injecting pure pregnancy hormones into your body. I didn’t have high hopes, though my husband did. I went to work as usual and waited. At 11:30, the clinic called me. I WAS PREGNANT!!! I promised my husband that he would be the first person to know, and I didn’t get off until 2, so that was a long time to hold in the good news, but I did it. After work I bought a cake and had the decorator write “We’re Pregnant!” on it. I took it home to my husband and we celebrated. My way of celebrating was cake; his was sex (such a guy).

     Shortly after celebrating, my husband had to go to work. Around 7:30 pm, I went to the bathroom, and noticed blood on the toilet paper and in the toilet. I was TERRIFIED! This was the first day of our pregnancy, and it was already over. I called the emergency number at our doctor’s office to report the bleeding. Our doctor was fairly confident that I was bleeding post sex, just like the week before; but as a precaution, she increased my estrogen to twice a day, and put me on bed rest for the weekend. It’s standard procedure when using fertility treatment to repeat the pregnancy test four days later to ensure that you are not having a chemical pregnancy. I was on bed rest until Tuesday when I would have the tests repeated. That weekend, I didn’t move unless absolutely necessary. I was desperate to keep the baby in. On Tuesday morning, my blood work revealed that not only was I still pregnant, but that my hormones had tripled over the weekend. They only need them to double. It was official. I was pregnant and due April 3^rd.

     At six weeks, we had our first ultrasound. Our clinic does ultrasounds every two weeks for the first 12 weeks. At the first ultrasound our baby looked a lot like a lima bean hanging in my uterus. But, the coolest part was hearing the baby’s heartbeat. That has to be the most beautiful sound I’ve ever heard in my life. This ultrasound also confirmed that I was only carrying one baby. The second follicle was still in my ovary, but was shrinking, so there was no cause for concern.

     After the ultrasound, we met with our nurse Nicole. Nicole is amazing! She gave us all the information we needed, and answered a lot of questions we had. Nicole was assigned to our case, which meant we would be seeing her after every visit we would have at the clinic until we were released to our regular OB at 12 weeks. I’m so thankful for her, because she was literally there holding my hand to see me through the tough first trimester.

     Speaking of the first trimester… Morning sickness is a lie! I’m sick all day long. The mornings are worst, but I’ve thrown up in the middle of the night when I’ve woken up to pee. Besides the morning sickness, I’m exhausted worse than I knew I could be. But, all these symptoms have actually helped me. Every morning that I wake up nauseous, I know that our baby is still wiggling around in my belly (something we witnessed for the first time at our eight weeks ultrasound).

     After our 10 weeks ultrasound, the doctor ordered blood work they call “the panel”. This group of tests includes everything from cystic fibrosis to genetic disorders that I could be a carrier for. These tests do not prove the baby will have any genetic disorders; it only shows the mutations that could complicate my pregnancy. My husband and I elected not to have genetic counseling done to test if we were both carriers for genetic disorders, but this test could help save the pregnancy if there were any complications, so we agreed to it. It turns out that it was a good idea to have these tests done, because I actually do have two different genetic disorders. The first mutation is called MTHFR, and effects 50% of the population. It basically means that my body doesn’t absorb folic acid properly, which is necessary for baby’s brain development. To combat this, I have been prescribed an additional folic acid supplement. The second mutation is called Factor V (five). This one is a lot rarer and a lot scarier. Factor V is a blood clotting disorder that has been known to cause late term miscarriages. In order to prevent the blood clots, I have been prescribed a daily injection of blood thinners. These injections are injected daily into my stomach, and burn like a fire in my abdomen. Even worse, the injections bruise my stomach so badly that I look like the baby I'm carrying is half Cullen. It is possible that I may not have to continue the injections, but I won’t know that until I meet with the high risk pregnancy specialist that I have been referred to. If I do have to continue the injections for the duration of the pregnancy, I will be induced at 38 weeks, instead of being allowed to go into labor. The day before I am induced, I will stop the blood thinners, so that I don’t bleed out during delivery.

     On Thursday, we had our final appointment at the fertility clinic. It’s truly amazing to see how much our baby has grown since that first ultrasound. And, the heartbeat is still the best sound I’ve ever heard. Friday, we went to our first OB appointment. And, Wednesday we will see our specialist. As scary as these first 12 weeks have been, our OB feels confident that we can start spreading the news of our little miracle.

     This baby is truly a miracle. An answer to prayer. Thank you, Lord for being the artist You are. A musician who knows that a beating heart can bring anyone to tears. I am truly grateful for the opportunity to bring this child into the world and raise it in His love. Amen! 

Believing Unbelief

            Five needles have gone into my body in five days. I have also had three ultrasounds in five days. Still no good news.

            On Thursday, we went back to the doctor, and things looked promising. I had six(!) follicles ranging in size from 12mm-7mm. A healthy follicle needs to be at least 14mm, but you have the best chance of there actually being a viable egg present if it is 18mm. My blood work (needle number one) showed that my estrogen levels, while still low, were rising. This was also a good sign. In order to ovulate that is one hormone that needs to be elevated. If you are a regular reader of my blog, you know that I typically have low testosterone levels, which is a common symptom of PCOS. I left the doctor’s office with instructions to return Saturday morning for another ultrasound and more blood work (needle number two).

The doctor was thinking that since there were follicles, and there was growth that maybe my ovaries just needed some more time; but when I had my ultrasound on Saturday, things were not any better. In fact, the follicles were shrinking. Now my biggest was only 10mm, and the others were so small that they didn’t even both to measure them. I left the office with four vials of Bravelle (.75ml each), some sodium chloride to dilute the powder, and several needles and syringes that I was supposed to use to give myself an injection on both Saturday and Sunday evenings in my thigh (needles three and four). I hate needles! I can tolerate having blood drawn a lot better, since I have had it drawn nearly every time I have gone to the doctor for two years, but shots… Not for me. The needle goes in so far, which hurts, and then you push a plunger down, which hurts more. That isn’t even noting that the medicine burns a bit as it goes in. Needless to say, I was not looking forward to the Bravelle.

On Saturday, I actually went to my husband’s work to have him give me the injection. I really knew in my heart that I couldn’t do it to myself. We locked ourselves in an officer’s office, I pulled down my pants, and we mixed the medicine. My hands were shaking as I was trying desperately to make sure there were no air bubbles and that I drew out all the solution. I put my hand on my thigh the way the nurse had showed me to help measure, and I smoothed out the skin so that my husband could plunge the needle in. In the haste and shear panic I felt having the needle in my thigh, I helped him push it in deeper, and pressed down the plunger myself. This was a big mistake. I forget a pivotal step: pulling back on the needle to make sure there was no blood present from hitting a vein. When we pulled the needle out, it was literally like a horror movie as blood shot out of my leg. My husband put his hands on my bleeding thigh to keep pressure and it eventually stopped, but it really hurt, and now I have a bruise.

On Sunday, we were able to do the injection at home without any difficulty. No veins hit. No bruise. And, mostly that’s because this time, I didn’t even look. I’ve decided that is a much better way to handle these things.

This morning we went back in for a third ultrasound and my fifth needle for more blood work. The hope was that the follicles would be further matured, and that my estrogen levels would be a little higher. I actually had more follicles today than Saturday, but the biggest was still only 12mm. I have been sent home with more injections, and a follow up appointment scheduled for Wednesday, but I don’t know for sure if this plan will be what the doctor recommends once she has my blood work back.

This whole process is exhausting, and it wears you down. My husband and I had our first “fertility treatment fight” on Sunday. I was trying to tell him that I didn’t want to look at the needle, or help him put it in, because all day I was picturing it in my thigh, and it was making me sick. He laughed, and told me I was over thinking everything, which is partly true, but also pretty unsupportive. Through tears I told him that in this situation he gets to have all the fun, and I do all the work. Think about it. His whole process of making the baby is getting to have sex with me. I, on the other hand, take eight pills a day, and now have to give myself injections. I also told him, that I don’t care if he thinks he could handle any of this better than me, because, the truth is, he can’t! So, he needs to make me feel like I am doing a better job than any woman before me. I need him to reassure me that this is not all for nothing, because I’ve reached a point of feeling both utterly hopeless, and completely hopeful. My husband is a very supportive and understanding man, but yesterday he wasn’t. He redeemed himself today, by going with me to my appointment this morning after working all night.

Feeling both hopeless and hopeful makes my heart feel like it’s on a rollercoaster. I keep coming back to a verse a good friend of mine shared with me in college: “I believe; help my unbelief” (Mark 9:24). I feel this struggle within my soul. I’m angry with God, because He isn’t healing my body fast enough. I’m thankful to God that we haven’t lost a child during this process. I’m mad at myself, because I feel as though I am being punished for something I did in the past; what I don’t know. I’m thankful that my husband has super sperm, so that we have a better chance. I feel guilty for being the problem. And, all these emotions are intensified by the fact that I’m injecting hormones into my body daily. I want to believe it will be worth it someday when I am holding our baby, smelling that sweet baby smell, but most days I feel defeated. I usually try to end this blog optimistic that the next post I will have good news, but I just don’t feel that way right now. So, instead, I am asking for prayer. Prayer not only that this will work, but that I will have the heart to see it through.

Cysts and Super Sperm

Fertility treatment is a roller coaster. One month you’re up. One month you’re down. It’s physically and emotionally draining. And, just when you let yourself get your hopes up… another cyst.

Last month, I went to our new clinic to get an ultrasound and blood work. It was day two of my period, which is a very awkward time to get a transvaginal ultrasound. During the ultrasound, the nurse discovered a cyst on my left ovary that was too large for me to safely continue treatment that month. In hindsight this was actually a very good thing. It meant my back injury from a recent car accident would have more time to heal before I start growing something in my uterus adding extra weight and stress to my sore lower back. But, at the time, it felt devastating.

In order to rid my body of the cyst, I was prescribed a one month cycle of birth control, and told to come back for another ultrasound day two of my next period. As it turns out, that day is today. So, this morning, I went back to the clinic with fingers crossed that my ovaries would be cyst free. When the sonographer looked at my uterine lining, it looked wonderful. And, when she looked at my ovaries she said, “Your ovaries look beautiful today!” Maybe that isn’t your typical compliment, but it meant everything in that moment to me. My left ovary has a small follicle that was collapsing, but not enough to worry about, so we are moving forward.

Tomorrow I will start our third round of Clomid treatment. (The first at this clinic.) I will be taking four pills a day (two in the morning and two in the evening). This is a higher dose than I took last time. Since I have successfully ovulated on Clomid before, there is a good chance that I will do it again. Plus, this clinic actually has me on a 31-day plan. I will be monitored every step of the way. In fact, next week I will return to the clinic for another ultrasound, and a HCG trigger shot to induce ovulation. I will have two more “mini shots” of HCG to help maintain a pregnancy, as well as two estrogen supplements at the end of the cycle.

We were given an option with this cycle to choose Intrauterine Insemination (IUI), or sexual intercourse. IUI holds a price tag and sex is free (not to mention a lot of fun), so we were hoping to do this the good old fashion way (you know, besides the ovulation stimulating medication). But, in order to give sex a try, my husband had to get a semen analysis test. To me, this is one of the most humiliating things you can do in a doctor’s office, but my husband is a trooper. Although we did not discuss the details of his “sample donation”, I know he did it. Later that day, I got a phone call from the clinic with his results. His sperm count was above average, and the sperm’s mobility is also very high. My husband has often joked that he knows he can get me pregnant, because he has super sperm. As it turns out, he’s right! These results do not guarantee pregnancy, of course, and we may need to try IUI some time, but this month is not that time.

Next week, my husband and I will be celebrating our two year wedding anniversary. We planned a long weekend getaway to Hot Springs, AK. We are both praying that that time will be the last that we are alone.

Brighter Days

            On Monday of this week we had our first visit to our new doctor! If you are regular reader of this blog, you know that we have not had the best luck with our last fertility specialist. He is a very unpleasant man, with a serious lack of bedside manner. After he told us we were wasting our money seeing him, I booked an appointment at a new clinic. The clinic is called CORM, and is so close to our house that I cannot believe we were driving on the other side of Houston before. Anyway, one of the best parts about this new clinic is that our specialist is a female. Don’t get me wrong, I don’t necessarily think women make better doctors, but when it comes to dealing with my most intimate regions, I would prefer a woman to a man.

            Dr. Schnell is one of two doctors in the practice, and she really is very sweet. Although, we waited in her office a long time to see her, when we were with her she was thorough, professional, and very good at answering all of our questions. She did a physical exam and ultrasound on me, and talked to my husband and me at length about our treatment options. During the ultrasound, she confirmed that I did, in fact, ovulate this last cycle. But, I was not pregnant, a fact I knew because I had just finished my period. I told her about the pain I had during my last cycle, and she agreed that it was most likely due to overstimulation from having two cycles of Clomid back to back without a period in between.

            We learned a lot from this visit. I knew that PCOS made up the majority of female related infertility, but I had no idea that 40% of infertility patients are due to male infertility, caused from slow swimmers to low sperm count and everything in between. My husband has not had a semen analysis done yet, but he will be having one soon. We don’t really have a reason to believe he has issues with his sperm, but you never know. Incidentally, he’s not really looking forward to this test, because, as you can imagine, it is awkward to produce a sperm sample in a doctor’s office.

After my exam, Dr. Schnell spoke with us again about another test she wanted to conduct on me. The test is called a Hysterosalpingogram (HSG). Basically, an HSG is an x-ray conducted after dye is injected into the uterus through a catheter to check if the fallopian tubes are open. This test is usually a test given early in treatment between days 5-10 of a cycle. I had asked for this test repeatedly when we were seeing Dr. Smith. And, although it is normally one of the first and most basic tests, he told me that I did not need it. After seeing Dr. Schnell one time, she ordered the test, and I had it done yesterday. Amazing how much faster things work when you know what you’re doing! I was given a Valium for the test in order to relax the uterus and lessen some of the pain. The test isn’t painful, but it’s uncomfortable. A catheter is thread past the cervix into the uterus where a small balloon is inflated to prevent the dye from leaking out. The balloon is the most uncomfortable part of all of it. The pain is like a normal menstrual cramp. I actually got to watch the dye fill my uterus and flow through both fallopian tubes on the screen. The entire procedure probably took 10 mins, at most. And, the results… ALL CLEAR! This means that when I ovulate, the egg has a clear path to the uterus.

But, the successful HSG isn’t even the most exciting thing to come out of our visit with our new doctor. The best thing is that SHE HAS A PLAN! Every time we saw Dr. Smith, the plan was always to wait and see. There was no clear path. But, Dr. Schnell has a 31 day pregnancy plan. We will go back to see her on May 8^th to start a new cycle. First, I will take a medicine to induce a period (not Provera, which I hate). Then, on day three of my cycle I will start Clomid. She is increasing my dose to four pills instead of three, and I am starting the pills two days before Dr. Smith had me start them. On day 11, I will have an ultrasound, begin taking an estrogen supplement, and receive an HCG trigger shot. Over days 13-15, my husband and I are to have sex, or if his semen analysis is not so great we can opt to do IUI (artificial insemination) with his sample. (The IUI is more effective because it forgoes the sperm traveling through the cervix in order to reach the egg.) Here’s where things get really tricky, I will have another ultrasound, another oral estrogen pill, and two more HSG shots between days 18-31. The extra two trigger shots are smaller doses than the one that forces ovulation. They are used to maintain the egg growth, so that I have a greater chance of not miscarrying early in the pregnancy. HSG is the pregnancy hormone; it is what causes the home tests to give you a positive, so it is not harmful to the baby. After this entire process has concluded, if we are still not pregnant, we will revise the plan and try a more aggressive treatment.

I am happy to report that Dr. Schnell only took me off one medication Dr. Smith had me on, the estrogen supplement. According to Dr. Schnell, if you take this pill daily, it makes it more difficult to get pregnant. It is best to take a higher dose for a few days during the cycle. Since the estrogen I was taking was only available from a pharmacy that did not take my insurance, my husband and I were both pleased to not need it anymore.

In general, things are looking up. I really have a good feeling that we will get pregnant before the end of this year. This new clinic is professional, friendly, and technologically advanced. (They use computers- a concept that Dr. Smith never got.) I’m looking forward to our next visit with Dr. Schnell, and if the worst part is the long wait times in her waiting room, then I would still say she is worth it.

Ice Cream Is Essential When You're Wasting Money

     Since my last post, a lot has happened, but it was really difficult for me to find the words to express how I was truly feeling, so I let my blog rest on a cliffhanger. Let me begin with three weeks ago.
     We went back to our doctor to follow-up on my egg situation. The hCG shot was supposed to force ovulation, so there was a chance I was pregnant. I took a home pregnancy test before scheduling my appointment, and it was negative, so I didn't really have high hopes that I was pregnant. However, I had every symptom you can imagine, literally. I woke up with a sore throat one day, a symptom I didn't even know existed. I also had an egg white discharge, which kind of freaked me out at first, because I didn't realize that was also a normal symptom. The problem is that despite all these symptoms, I wasn't pregnant. The trigger shot made my body behave pregnant, and my heart was just along for the bumpy ride. At our doctor's visit, I assumed our doctor would do blood work, because he ALWAYS does blood work. But, he didn't. He told me that I was unlikely pregnant, and that my testosterone levels had gone back up in the blood work he had taken last time. He also said that while it was possible that the presence of follicles at the last visit could have caused the hormone change he doubted it. But, he didn't do ANY blood work to confirm, even after I asked/ told him he should. The whole situation really pissed me off! My husband and I live about an hour away from his office and we waited 30 mins to see him, and HE DID NOTHING!
     I haven't really trusted Dr. Smith since he said I was closer to a daddy than a mommy, but this visit was the last straw. In fact, his new treatment plan seemed so poorly thought out, I was a little embarrassed to tell people for fear they would judge me for sticking with a bad doctor. His plan was to wait a few days, take another home test, and start another round of Clomid (with an increased dosage) without having a period. I knew from the ultrasound the last time that I had a uterine lining build up, which needed to be cleared out for my own safety, but the doc told me, "Your body doesn't follow the normal rules, so it will be fine". I was pissed.
     My husband and I really don't fight a lot. We disagree, discuss, move on, but fight... we just don't. But, that day, it was brutal. I told my husband that I didn't want to continue with our doctor, because I didn't trust him, and I was scared for my body to build up this lining and not shed it, because it can be toxic. My husband is normally fully on my side, but this time he wasn't. He thought I was trying to change doctors so that I could move to a more aggressive treatment too soon, which he didn't think was a good plan at all. I agree that moving faster than normal through procedures was a bad plan, but that was not what I was doing. After, literally three hours discussing it, my husband agreed that a second opinion wasn't a bad idea, especially since I was actually willing to postpone treatments altogether to ensure that what our doctor was prescribing was the best. We agreed to look at another clinic in April if round two of Clomid failed.
     Fast forward to this week... After five days on Clomid, and 14 days of waiting, we had another follow-up. While on Clomid this time, I had the same side effects as the first time, light cramping and mood swings. But, this time, I had a significant temperature drop (the first sign of ovulation) right on schedule! A few days later (Tuesday of this week), I had the same white discharge, which can also signify ovulation is starting. Then, on Wednesday I was sitting at my desk at work, when out of nowhere, a blinding pain hit both sides of my ovaries. It hurt so bad I thought I would throw up. And, the pain did not dissipate for over two hours. After the first hour, I called the doctor. I didn't hear back until much, much later, after the pain had subsided to a dull ache. His nurse said to take some Aleve, but since our appointment was the next day there really wasn't much else to do.
     At our appointment yesterday, Dr. Smith looked at my temperature chart, which featured another significant drop from that very morning, and said he didn't think we needed to do an ultrasound, because he didn't think there was anything going on. I sort of insisted that we do the ultrasound, since that was really the only way to be sure, and since I was still in a little pain it would be nice to know why. The ultrasound revealed that I had a lot of small follicles, and two large ones (one on each side), but it also revealed that the large one on the left had ruptured, and was caving in on itself. This was the pain I felt. There is no real way to tell if the ruptured follicle contained an ovum/ egg, or if it was just filled with liquid, but there was liquid present, which was a good sign that something was actually happening in my ovaries. The follicle on the right side, may or may not rupture to leak the ovum or liquid out this weekend. There's really no telling. So, he ordered some blood work to check my estrogen and progesterone levels, which would be a clearer view of ovulation. I won't have those results until Monday, but the doctor had some advice for us. He feels as though Clomid may not work for us, because there is a chance that my ovaries have a thick "shell" built up on them, which is common with PCOS. He also feels that the best way to treat it is to drill holes in my ovaries to make a path for the eggs to escape from. The procedure has had poor results, and he doesn't know a doctor in all of Houston that does it. So, this was less than helpful, to say the least. Our other options could be to move to IVF, but he doesn't think my body will produce viable eggs, despite the fact that Clomid is producing follicles that are the right size and shape. He concluded his recommendation by saying, "I feel like I'm wasting your money". And, in that moment, my world shattered. HE HAS GIVEN UP! I am grasping at straws of tiny successes, and he is throwing in the towel. It was all too much to handle, so this time I did cry in his office. And, I didn't stop crying for nearly the whole hour drive home.
     As is our routine, my husband and I discussed the visit on the way home. He said he doesn't think Dr. Smith is right, and he wants the second opinion. While I was hurt, my husband was angry. He couldn't believe our doctor would give up when there was literally proof that my body was responding to treatment even in the slightest. When I suggested maybe we should explore adoption, something we have not done, because we weren't ready to quit trying yet, my husband said we could look into it, but he still wasn't ready to give up. We are so early in the process that it doesn't make sense. Plus, there is a chance I am ovulating right this very moment. My husband was right. It isn't time to give up. I told him that I do not want to have my ovaries drilled, but, if we have to move to IVF, then we should start saving.
     Today, I feel awful. I have dull, achy cramps on both ovaries that feel sort of like someone poked them repeatedly with a stick, which is pretty accurate, I guess. I'm writing this while drugged up on Aleve and resting on a heating pad. But, the second I hit "Publish Post", I am calling the fertility clinic we chose for a second opinion.

Eggs before Easter

Wednesday, we went back to the doctor to follow-up. I had taken the Clomid, and given it two weeks to work its magic. The hope was that in that time, I would have produced follicles and ovulated. I had absolutely no desire to visit our doctor this week, because I knew in my heart that it hadn’t worked, and I really didn’t want to face the disappointment. I took home ovulation tests to check for an LH surge signifying the start of ovulation. Nothing happened. And, although my temperature had dropped, another early sign of ovulation, I really knew my body didn’t respond to the treatments. My always encouraging husband grabbed my hand and reassured me that if we didn’t go to the doctor, we wouldn’t know for sure, and we couldn’t really start over. He was right, so I reluctantly gathered my things, and we drove the 45 minutes to the doctor.

I had a lot of side effects on Clomid, including pain in my lower abdomen where I assume my ovaries are located. The pain was worse on the left side than the right, and in both cases was more like a dull, achy pulsing than a sharp pain. I didn’t want to tell Dr. Smith about the pain, because I figured he wouldn’t want to let me try again on Clomid. But, I also knew it was important for my care. The doctor told me that in some cases this sort of pain is normal, and a good sign that something is stirring in the ovaries. He suggested we do a physical exam before my blood work.

The exam showed that my body was producing cervical mucus, which is a good sign that ovulation is possible. And, that once ovulation occurs, pregnancy is possible. After, he suggested we do an ultrasound to check out my ovaries. I got dressed, changed rooms, and another doctor (Dr. Rodriguez) met us there to conduct the ultrasound. The first picture was of my uterus. The first ultrasound Dr. Rodriguez did on my uterus, last summer, showed absolutely no lining build-up, which was kind of a blessing, because I hadn’t had my period in about three months at that point. But, this ultrasound showed a lining ready to be a womb. Both doctors, my husband, and I celebrated the small victory. Then Dr. Rodriguez moved to my right ovary, which contained one follicle. The follicle wasn’t quite big enough to produce an ovulation resulting in pregnancy. So, he moved to the left ovary. As soon as we could see it on the screen, both doctors yelled out, “There you go!” And, there on the screen, was a follicle perfect in size and shape waiting to be coerced down my fallopian tubes! I looked at my husband and we just smiled! It was amazing. The Clomid had produced one, possibly two, follicles!

Dr. Rodriguez looked at us and said, “No triplets this round,” as he exited the room. My husband and I just laughed, because my mother is so convinced we will have triplets; a fact we have never discussed with either doctor. Then, my husband gave me the “I told you so look” as we sat back down with Dr. Smith to talk about what’s next. Since my body was able to produce a follicle, but not actually ovulate it, I had to get a shot of hCG. hCG is a hormone found during pregnancy. It is actually what home pregnancy tests are looking for. But, it has been proven to force ovulation in women. But, I HATE NEEDLES!!! I am such a baby about it, and the thought of having my husband push medicine into my arm terrified me a bit. I keep reminding myself the endgame is worth it. The hCG has the potential to push the egg (or both eggs) out within 36 hours. If it worked we’ll know in several weeks, because I will either be pregnant or have my period. If it didn’t work, we’ll probably repeat the same steps again next month. With the Clomid and hCG, we still only have a 30% chance of becoming pregnant.

The truth is, even if this month we do not get pregnant, I am still praising God that my body produced even one healthy follicle. I was so convinced it wouldn’t work on that dose. But, it did! I am asking for continuous prayers, because it’s still a long journey. I thank all of you who read this blog and pray for my family, because God is moving mountains right now in my body.

And I'll be awful sometimes. Weakened to my knees. But, I'll learn to get by on the little victories.

Today, I started taking Clomid. It feels like a long time coming, considering that my husband and I have been seeing a fertility specialist since November 2010, and have been seeing our current doctor for just under a year. But, here we are. I feel a little hesitant to write an entry today, because I didn’t want to give people false hope. I guess, the truth is, I really don’t want to give myself false hope. Clomid has a 35% success rate. This is actually the same percentage a fertile-aged couple with no signs of infertility has of getting pregnant each time they are sexual active during ovulation. It seems so low to me, but those are the odds. Since my hormones are balanced (or at least they were at my last appointment), we now have the same chance as any other couple with the help of Clomid. That’s pretty amazing to me. But, 35%? How does anyone get pregnant with those odds? I feel like we just climbed the first peak of Everest, only to look up, and realize there are many, many more miles to go. I believe this will work for us (I believe, help my unbelief.- Mark 9:24), but how many tries will it take? What is the right dosage for my body? These things are so subjective, and not even my doctor can answer for sure. Fertility medicine is all trial and error. And, that is scary as hell to me. My body is exhausted from just the past three weeks of preparing to take the Clomid.

On January 13^th, I started Provera. Provera is a drug that induces a period. Gynecologists believe that it is unhealthy for the female body to go longer than three months without a period (except obviously during pregnancy), so they frequently put irregular woman on birth control to produce a period each month. If you are trying to get pregnant, then birth control is obviously a poor choice, so the other option is Provera. I HATE Provera. The drug makes me feel awful! I have premenstrual cramps for the whole 10 day cycle, plus the 10 days in between before my period starts. And, I am so nauseous that I don’t really want to eat. This time, it actual made me vomit. I feel fatigued, weak, unmotivated, and irritable. It is really not a fun medication. Plus, when my period does come the cramps are so bad that I feel nauseous again. So basically, I have felt like absolute crap for a month.

In the past when I have taken Provera, my period is weak flowing, but painful. This time it was less painful and heavier. Maybe I am looking too much into this, but I think that was a good sign. When I have taken the medication before, I had low levels of estrogen, and the doc was trying just to clean me out, because a lining build up can be dangerous. But, I know from my previous ultrasounds that my lining doesn’t really build up on its own because the hormones that make that happen are too low to do their job. This period more closely resembled those I had on birth control when there was a higher level of estrogen present in my body. I am chalking this up to a small victory that the estrogen supplements are causing my body to produce a lining, but not ovulation. Enter the Clomid.

Clomid’s job is to stimulate the ovaries to create follicles and induce ovulation. It increases your chance of twins by 50%, but is not really known to produce higher sets of multiples (though it has happened). The beginning dose is 50mg once daily for five days. The dose is increased if it is unsuccessful the first time. Dr. Smith started me on 100mg for five days. Essentially, we skipped step one. Typically, if a patient takes 200mg and uses the “trigger shot” of hCG hormone with no successful ovulation then Clomid will not work for the woman. (Note- hCG “trigger shots” are given during the third step of trying Clomid.) Since there are so many trial and error steps even this medication can be a long process, depending on how persistent the doctor is with the medication. Since today was day one for me, I will go back to the doctor in two weeks. At that appointment, he will run lots of blood work to check for ovulation and/ or pregnancy, perform a physical exam to check for signs of a thickening cervix, and discuss what the results mean. We obviously won’t know the blood work results the same day, but usually the physical exam is enough to determine pregnancy. The blood work will confirm if the Clomid induced ovulation even if we are not pregnant.

I plan to use the home ovulation tests to better time sex, but we have been instructed to be intimate every other day from now until our appointment. And, I will say, I am happy that although we will be having sex on a schedule, neither of us feels negatively about it. We both know that a lot of couples sort of get bitter in these situations, usually because the female is looking only to get pregnant and it can deplete the intimacy of sex. I love my husband very much, and sex is a very active part of our marriage. I want to get pregnant, but I don’t want him any less.